Provider Demographics
NPI:1013014323
Name:YOUNG, MELANIE A (APRN)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:A
Last Name:YOUNG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 SILK FARM ROAD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301
Mailing Address - Country:US
Mailing Address - Phone:603-226-3140
Mailing Address - Fax:
Practice Address - Street 1:333 DANIEL WEBSTER HIGHWAY
Practice Address - Street 2:MERRIMAC COUNTY NURSING HOME
Practice Address - City:BOSCAWEN
Practice Address - State:NH
Practice Address - Zip Code:03303
Practice Address - Country:US
Practice Address - Phone:603-796-2165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH038425-23-03363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30008012Medicaid
NH30008012Medicaid
NHS59792Medicare UPIN